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Q&A Addresses Ebola and Travel Concerns

What is Ebola and should our community be anxious about catching this infectious disease?
Ebola is a viral infection that is actually hard to “catch.” While it typically occurs in Africa, the first case diagnosed in the United States was a man who traveled from Africa to Texas in October. Compared to other viruses, such as the measles, Ebola is not very infectious. To become infected, a person would have to have significant contact with bodily fluids of someone with the disease. The infection is not airborne. Unless someone travels from an infected area in Africa to our area, it is unlikely Indian River County will be affected.

Is a person who travels more likely to be infected with Ebola?
General contact, such as sitting in an airplane, riding in an elevator, or even being in the same room with someone who has Ebola is generally not a concern. However, people should avoid travel to the West Coast of Africa where the epidemic seems to be centered. While Nigeria is now Ebola free, the Ebola outbreak is active in Sierra Leone, Liberia and Guinea. There is no indication that Ebola has spread outside those areas with the exception of a few cases, all of which are related to travel from Africa. Generally speaking, it is safe to travel.

How can a person tell if he or she has the flu vs. Ebola?
Ebola is tricky in the way it presents. It can incubate for two to 21 days but most people show symptoms after exposure in about seven to 10 days. The tricky part is the symptoms. Typically, like any viral illness at the beginning, the patient may have conjunctivitis (‘pink eye’), swelling and irritation of the eyes, sore throat, high fevers, chills, nausea and/or diarrhea. With Ebola, however, it progresses with liver failure, kidney failure, low platelet (blood component) count and bleeding from orifices. When symptoms progress to lung failure and heart failure, the disease has a fatality rate of 50 percent. To answer the question, neither a person nor a healthcare worker can distinguish between the flu and first symptoms of Ebola. Everyone should use universal precautions and avoid contact with bodily fluids of anyone showing flu-like symptoms.

What does contact with bodily fluid mean?
Blood and bodily fluid transmission includes saliva, vomit, coughing, blood, urine, feces, etc. touching an open area of the skin. A unique characteristic with Ebola is that people who survive the disease are able to transmit it sexually for up to three months afterwards. So it is important for those who survive Ebola to not have sexual intercourse with their partners for at least three months.

Why are healthcare workers at high risk for being infected with Ebola?
The one group of people that seems to be uniquely susceptible to Ebola is healthcare workers. In countries outside the United States good infection control is difficult to achieve so people don't necessarily have the best barrier protection such as masks, gowns and gloves. When patients with Ebola start showing symptoms, they are very sick and very infectious. Because of the degree of the virus in these very ill patients, healthcare workers are more vulnerable.

Do you think this will turn into a plague?
Ebola is not very capable of transmission. It won't become a plague. In comparison, measles is 10 times more infectious than Ebola since measles is airborne and you only need minimal contact with another person to transmit measles. However, Ebola is very lethal with a 50-60 percent mortality rate, especially in Africa, due in large part to the lack of healthcare resources, such as IV fluids and only symptomatic treatment being available. In modern medicine areas such as the West, Europe, Australia, the United States and Canada, the mortality rate is about the same as yellow fever, a similar virus, about 20-30 percent.

If people are concerned about travelling overseas, where can they turn for information about potential medical issues related to the countries they are about to visit? Also, if someone becomes ill after travelling overseas, where can they seek assistance?
Indian River Medical Center offers a Travel Medicine Clinic. Dr. Charles M. Phillips and I are able to research areas that people intend to travel to determine if any vaccinations or other precautions are needed. Likewise, as board certified infectious diseases specialists, we are uniquely qualified to assist travelers who return home in poor health to ascertain if there might be an infectious component related to the countries they visited, and provide appropriate treatment and medications. To request a Travel Medicine Clinic brochure, phone 772.567.4311, ext. 36125.

Read Dr. Mackett’s message regarding IRMC preparedness.

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